Medicaid Policy & Regulation Analyst

This is a fully remote position, open to applicants in Connecticut, +9 more states.

📋 Description

• Conduct research, comprehend, and clearly express Federal and State regulations and policies regarding the administration of State Medicaid programs within the northeastern jurisdiction.

• Act as a subject matter expert on Medicaid programs and the specific nuances of each state.

• Research and educate the wider Medicaid team in collaboration with project development or referrals.

• Clearly communicate policies and regulations both in writing and through discussions and presentations.

• Contribute to written policy for Analytical Findings Reports.

• Collaborate with Project Coordination and Data teams to identify relevant projects.

• Spot potential vulnerabilities in programs that may arise from policy research.

• Engage in policy discussions with states in the jurisdiction.

• Participate in policy discussions with CMS.

• Keep abreast of emerging issues and developments impacting state Medicaid programs.

• Assist the Medicaid Operations Lead with specialized research projects.

• Take ownership of the Medicaid Policies & Procedures Manual, reviewing and updating it annually as required.

• Monitor the policy workload and provide monthly reports to the Medicaid Operations Lead.

• Manage state meeting agendas and minutes in collaboration with the Business Analyst.

⛳️ Requirements

• 5 years of experience with a BS/BA degree or 9 years with a high school diploma.

• Minimum of 5 years of experience in policy research and analysis.

• Capability to present and discuss state policies and regulations in relation to project impacts.

• Proficient in researching policies and interpreting regulations and regulatory guidelines.

• Strong interpersonal skills, with the ability to work independently and make decisions in both independent and team settings.

• Exceptional planning and organizational skills.

• Outstanding oral and written communication skills; capable of conveying information and presenting to all levels of management and staff.

• Ability to meet deadlines and manage multiple customer service demands effectively.

• Flexibility to adapt to changing priorities; self-motivated and energetic attributes are preferred.

• Proficient in Microsoft Office applications: Word, Excel, Access, PowerPoint, and Outlook.

• US citizenship is required.

• Experience with CMS programs, including Medicaid and Medicare, is advantageous.

• Experience with Managed Care programs is beneficial.

• Familiarity with CMS regulations concerning State Medicaid programs, including waivers, is advantageous.

• Knowledge of CMS 64 and the ability to analyze and interpret reports to identify trends and vulnerabilities is beneficial.

• Understanding of the Federal Matched Assistance Program related to State Medicaid programs is advantageous.

• Medical coding knowledge or experience related to Medicare/Medicaid claims is a plus.

🏝️ Benefits

• Potential eligibility for overtime.

• Potential eligibility for shift differential.

• Potential eligibility for a discretionary bonus.

• Telework options available from all states and time zones.